Primary Specimen & User Manual - Irish Blood Transfusion Service

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IBTS/DIAG/GDE/0001 Ver. 1 Effective Date: 02 / 04 / 2009 Page 30 of 35Irish Blood Transfusion Service11.2.11Review of Serious Adverse Reactions and Serious Adverse Events should be undertaken at eachHospital Transfusion Committee Meeting. Where invited, the Irish Blood Transfusion Serviceconsultant haematologist will attend such meetings.12.0 GUIDELINES: MEDICAL/SCIENTIFIC12.1 ANTENATAL GUIDELINESAnte Natal SpecimensIt is the policy of the IBTS to follow the UK BCSH Guidelines for Ante-Natal testingwhich includes the timing of Ante-Natal sampling for patients with and without Red CellAntibodies12.1.1. Specimens for Anti-D quantitation.The Biological Reference Ranges for Patients with Anti-D are as follows,Anti-D levelIU/mlRisk ofHDNRecommendation0 – 4 Low risk Repeat specimens recommendedevery 4 weeks to week 28gestation, then every 2 weeks todelivery.4 – 15 Moderate Recommend referral to a specialistRisk Foetal Medicine Assessment Unit.Repeat specimens recommendedevery 4 weeks to week 28gestation, then every 2 weeks todelivery. Note: Subsequent referralfor Anti-D quantitation is oflimited clinical use once the> 15 HighRiskreferral has been made.Recommend referral to a specialistFoetal Medicine Assessment Unit.Repeat specimens recommendedevery 4 weeks to week 28gestation, then every 2 weeks todelivery.CommentsReferral of maternalspecimen to IBGRL forfoetal D genotype.From 16 weeksReferral of maternalspecimen to IBGRL forfoetal D genotype.Note: Subsequent referralfor Anti-D quantitation is oflimited clinical use.
IBTS/DIAG/GDE/0001 Ver. 1 Effective Date: 02 / 04 / 2009 Page 31 of 35Irish Blood Transfusion Service12.1.2. Ante-Natal Specimens for Antibody TitrationAnti-cTitre Recommendation Comment32 Recommend referral to a SpecialistFoetal Medicine Assessment Unit.Repeat specimens recommendedevery 4 weeks to week 28 gestation,then every 2 weeks to delivery.Anti-K N/A Anti-K can cause HDN irrespectiveof titre. Recommend referral to aFoetal Medicine Assessment Unit.Repeat specimens recommendedevery 4 weeks to week 28 gestation,then every 2 weeks to delivery.Check Partner’s Kk type. If Kellnegative and paternity can beconfirmed, repeat specimenrecommended at 28 weeksgestation. If partner’s Kell type is Kpositive or cannot be determined,then refer the maternal specimen forfoetal K genotype and advise repeatspecimens for antibody titrationevery 4 weeks to week 28 gestation,then every 2 weeks to delivery isrecommended.OtherClinicallySignificantAntibodies32 are consideredclinically significant for HDN.Referral to a Foetal MedicineAssessment Unit is advised.Referral of paternal specimen forantigen typing and /or maternalspecimen for foetal genotyping( if appropriate)Referral of maternalspecimen to IBGRL forfoetal Rh genotypeReferral of maternalspecimen to IBGRL forfoetal Rh genotype.Check cord DAT atdelivery and monitor infantfor evidence of haemolysis.Check cord DAT atdelivery and monitor infantfor evidence of haemolysisCheck cord DAT atdelivery and monitor infantfor signs of haemolysis
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Primary Specimen & User Manual - Irish Blood Transfusion Service

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